Holmström Gerd, Hellström Ann, Jakobsson Peter, Lundgren Pia, Tornqvist Kristina, Wallin Agneta
Department of Neuroscience/ophthalmology, Uppsala University, Uppsala, Sweden.
Section of Pediatric Ophthalmology, The Queen Silvia Children's Hospital, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Br J Ophthalmol. 2016 Dec;100(12):1656-1661. doi: 10.1136/bjophthalmol-2015-307263. Epub 2016 Mar 11.
BACKGROUND/AIMS: Retinopathy of prematurity (ROP) is a sight-threatening disease, requiring efficient screening and treatment. The present study aims to describe various aspects on treatment for ROP in Sweden.
Data on treatment for ROP in infants born in 2008-2012 were extracted from Swedish national register for retinopathy of prematurity, a web-based national register.
During 2008-2012, 3488 infants with a gestational age (GA) at birth of <31 weeks had been screened for ROP in Sweden. Altogether, 30.3% (1057/3488) of the infants developed ROP and 5.2% (181/3488) were treated. Type 1 ROP was found in at least one eye in 83.2% (149/179) of the treated infants. One third of the eyes (32.2% right, 29.9% left eyes) were treated more than once. Laser was the only treatment in 90% of the eyes. Mean number of laser spots at first laser session was 1177 and 1386 in right and left eyes, respectively. Number of laser spots correlated negatively with GA at birth (p=0.01). There was no change in frequency of treatment or number of laser spots during the 5-year period. Anti-vascular endothelial growth factor injections were performed in 28 eyes, encircling band was used in five eyes and vitrectomies were performed in seven eyes. Twenty-six retinal surgeons performed 9.4 (range 1-37) treatment sessions in the 181 infants.
The present study reveals similar incidences of ROP and frequencies of treatment during the 5-year study period. Many surgeons were involved in treatment of a rather limited number of infants. The results call for national discussions on organisation of ROP treatment.
背景/目的:早产儿视网膜病变(ROP)是一种威胁视力的疾病,需要进行有效的筛查和治疗。本研究旨在描述瑞典ROP治疗的各个方面。
从瑞典基于网络的全国早产儿视网膜病变登记处提取2008 - 2012年出生婴儿的ROP治疗数据。
2008 - 2012年期间,瑞典共有3488名出生时胎龄(GA)<31周的婴儿接受了ROP筛查。总共有30.3%(1057/3488)的婴儿发生了ROP,5.2%(181/3488)的婴儿接受了治疗。在接受治疗的婴儿中,83.2%(149/179)至少一只眼睛发现1型ROP。三分之一的眼睛(右眼32.2%,左眼29.9%)接受了不止一次治疗。90%的眼睛仅接受了激光治疗。首次激光治疗时,右眼平均激光光斑数为1177个,左眼为1386个。激光光斑数与出生时胎龄呈负相关(p = 0.01)。在这5年期间,治疗频率或激光光斑数没有变化。28只眼睛接受了抗血管内皮生长因子注射,5只眼睛使用了环扎带,7只眼睛进行了玻璃体切除术。26名视网膜外科医生为181名婴儿进行了9.4次(范围1 - 37次)治疗。
本研究揭示了5年研究期间ROP的发病率和治疗频率相似。许多外科医生参与了相对有限数量婴儿的治疗。这些结果呼吁就ROP治疗的组织进行全国性讨论。